Healthcare Provider Details

I. General information

NPI: 1649214792
Provider Name (Legal Business Name): KARI JOY TURYBURY RD LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARI JOY MEYER RD LD

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 PARK NICOLLET BLVD FAMILY MEDICINE NUTRITION
ST LOUIS PARK MN
55416
US

IV. Provider business mailing address

3850 PARK NICOLLET BLVD FAMILY MEDICINE NUTRITION
ST LOUIS PARK MN
55416
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-0785
  • Fax:
Mailing address:
  • Phone: 952-993-0785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: